Friday, February 25, 2011

Fever in Newborns

The other night Mary Abilene had a very, very mild fever. She was just a little hot to the touch and it lasted only a few minutes while she nursed and calmed down. But it prompted me to dig out one of my children's medical books. I found something worth sharing, since I maintain a natural birth blog.

This was in the fever section of Dr. Robert Mendelsohn's "How to Raise a Healthy Child... In Spite of Your Doctor" Dr. M is an M.D. and a pediatrician!

"Newborn babies may suffer from infections related to obstetrical interventions during the delivery process, prenatal or hereditary conditions, or events that occur shortly after birth. They may develop abscesses as a result of fetal monitoring prior to delivery or aspiration pneumonia from amniotic fluid forced into the lungs because of overmedication of the mother during labor. They may contract an infection from circumcision performed by the obstetrician before they left the hospital. Finally, they may develop infections from the legion of germs that abound in the hospital itself. (That's one of the reasons all of my grandchildren have been born at home!)" (pp. 76-77) He goes on to say that a baby in the first few months of life with a fever should always be taken to the doctor. He lists these reasons because he says that most fevers in babies and children older than a few months, do not warrant a trip to the doctor.

Thursday, February 17, 2011

Book Review: Secrets of the Baby Whisperer

Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate, with your baby
By Tracy Hogg

Sometimes I honestly believe that we would be the best parents we can be if we didn't read any parenting books. We would also have to erase, or deprogram, all societal influences in order to do what makes you, your baby, and your family happy and comfortable without outside influences of shoulds and shouldn'ts that we are all bombarded with unintentionally. Only then, would we do what makes us happy, what comes natural, without caring what any other parent or grandparent thought. But sometimes you need help, advice, or ideas. Sometimes, as a new parent, you just have no idea what to do so there is an endless supply of parenting books on the market and finding the ones that you like and agree with takes reading some that you dislike and do not agree with.

I didn't read any parenting books during my pregnancy. I couldn't even force myself to think past August 13 (my due date) I was so involved in my pregnancy. We did watch "Happiest Baby on the Block" (maybe I should do another post on that) but that was it. That DVD really helped with the first few weeks. We were happy, we were doing our own thing, we were parenting. Then along came "Secrets of the Baby Whisper". I read this book when Mary Abilene was one month old and I absolutely hated it. I got it because another parent at church talked about how it explains and decodes a baby's cries. That was exactly what I wanted as a new parent, to help me understand what my baby needed. However,the book only had a small section on decoding cries, and mostly made me feel like a bad parent, simply because I fed my baby more than every 2.5 - 3 hours. Hogg states that (paraphrased) "no healthy baby should nurse more often than every 2.5 hours." I now find that to be a completely misinformed statement. I since learned that every baby and every breast is different and there is no set time limit to put on feedings.

Before I embraced the fact that Mary Abilene and I were both perfectly happy nursing every two hours (until she was four months old, when she extended the time between herself) I tried to extend the time between her feedings. At one month old, it was the worst three days of my and Mary Abilene's relationship. She was entirely too young to be told when and when not to nurse, and I loved comforting my baby. We scheduled, charted, and tried other comforting measures before nursing, but she was HUNGRY and I was unwittingly depriving my baby. This is a recipe for breastfeeding disaster. Schedules inadvertently decrease milk supply, ESPECIALLY in the early weeks of a baby's life. Nursing often, round the clock, is healthy and natural and ensures a milk supply to meet the baby's needs. In short, I am very much an advocate for nursing on demand. Even if she just wanted to nurse for comfort, I find that completely acceptable and enjoyable to share that with her.

It took going through those three days and realizing that just because it is published doesn't make it right for us. I threw out the book and went back to our previous nursing dynamic. In short, I wish I had never read this book. I also have a major issue with step-by-step parenting books and books that claim always and nevers. Babies do not come with a manual for a reason - no two babies are the same. Any book that claims everyone should do this or no one should do that gets a grade F in my book.

Otherwise, the book is about "flexible schedules" with Eat, Activity, and Sleep rotating through the day, in that order. The sleeping section was also not for me. Hogg suggests putting a baby to bed awake because they "have to learn to be independent from birth". Although she doesn't advocate cry-it-out, her method is sure to cause a lot of tears. Hogg seemingly doesn't account for differences in babies and parents and doesn't acknowledge that there is truly no such thing as a "normal" baby.

There are a couple positive things I did get out of the book. One is to listen to my baby. Not to just assume I know what she wants when she cries (to nurse) but to listen to what she is trying to tell me. It is hard with a newborn, but as she gets older, she clearly expresses likes and dislikes, needs and wants, and listening to a baby from birth facilitates listening to your baby as she grows older. Another good point was to treat your baby like a person. Hogg suggests talking a baby through a diaper change, telling your baby what you are going to do, and asking permission to enter her space. "I'm going to pick you up now. Come to mama!" Instead of hoisting babies here and there with no respect to their own person. We still talk Mary Abilene through diaper changes and getting dressed and she loves it.

The book is very popular, so clearly other parents like the "flexible schedule" system. We, personally, do not put Mary Abilene on a schedule. She can't tell time! However, left to her own devices, she naps about the same time every day, goes to bed about the same time every day, and gets up about the same time every day. She ended up scheduling herself. I just do not think you can put a baby who is not sleepy to bed because the clock says so, or keep a tired baby up longer. I also do not believe in waking a sleeping baby. (This is not necessarily the advice in the book.) However, I do recognize that there are other families who very well may need a scheduled baby. Other children in the house is the first reason that comes to mind. Other families may not have the luxury of letting their baby run the show for one reason or another. Please recognize that I review this book with a newborn in mind. I absolutely believe in building a consistent and reliable routine for older infants and toddlers. I certainly do not think I will let a three-year old decide when she wants to go to bed! I do not mean to say that this book is unacceptable for every family, it just doesn't work for us.

Thursday, February 10, 2011

HAPPY BIRTHDAY, DOLL!

Happy Half Birthday to my dear sweet Mary Abilene!

(Her birthday was Tuesday. No, I didn't forget, I just forgot to post!)

She is doing great. She's a small one, 13.8 pounds and 26 inches long. She is happy, and healthy. We praise God for the gift of her. She has never been sick, also thanks to the Lord. She is loving sharing meals with us, and has eaten most everything we eat. Some things she gobbles right up. Baked sweet potato fries were really fun. She had one with the skin still on and she managed to separate all the potato from the skin. It was really amazing. Babies have skill! We just don't realize it until they have the opportunity to show off that skill. No matter if its eating, rolling over, crawling, or walking, given the chance, babies never fail to impress!

She has been drooling and chewing on everything in sight for months now, but still no signs of teeth. I didn't get my first tooth till 10 months, and Patrick was right at 6 months, so we'll see when she will get hers. I love her gummy smiles!

I can't believe half a year has gone by, and I don't even want to think of how fast the second half will go. Oh, my sweet baby girl!

Thursday, February 3, 2011

Baby-led Weaning




Baby-led Weaning:
Helping your baby to love good food.
By Gill Rapley and Tracey Murkett



I know it probably seems like we do everything different, and apparently feeding baby proves to be no exception. I always thought that I would make my own baby food, but when I learned about baby-led weaning, I thought it was even a better idea. I came across baby-led weaning accidently. Another blog website I frequent had a small excerpt about it since that was how they fed their babies. I looked it up and thought it was pure genius. Actually I really thought it seemed like common sense.

"Weaning" does not refer to weaning from the breast so much as it refers to the process of starting solid foods from exclusive milk feeds and eventually eating only solids. It is just that instead of being parent led i.e. the parent is in control of when, what, and how much baby eats, the baby is in control of this (solids and milk feeds).

"Forget baby purees, ice cube trays, and weaning spoons, and simply let your baby feed himself." The concept is that you offer your baby table food. Whatever you are eating (with a few exceptions), as long as it is healthy, whole food, you let your baby eat, in easy to grab shapes. The baby starts eating solids as actual solid food, at six months, or whenever the baby appears to be ready. At first the baby doesn't actually "eat" much. Meal times are considered play time, and the baby picks food up, sticks it in their mouth, gives it a gnaw and decides what to do with it. It will mostly get spit back out. As the baby learns more about food, that it tastes good, that it can be swallowed, and that it helps fill her up, more will be ingested.

I've found that there are more baby food myths than can be counted. A few include:
1) A baby has to start with mushy food, they will choke otherwise.
The book says that a baby in control of what she puts in her mouth is less likely to choke than a spoon-fed baby. This is due to where the gag-reflex is on an infant - not very far back. The baby would put food in her mouth at the opening, not in the middle where a spoon would go and this keeps the baby in control so the food does not go too far back. The baby may gag, but that is to move the food forward so they will not choke. The book also says that when a baby traditionally is allowed to feed themselves (8+ months) they are more likely to choke because they have not learned how to control the food and the gag reflex has moved back on the tongue.

2) You have to introduce one food at a time to see if they are allergic.
The book says that this old rule was based on the recommendation of feeding four month old infants solid foods. A four month old's digestive system is not mature enough to handle food at all, so the foods did have to be runny, mushy, one at a time, and simple. Until around six months, an infants digestive track is "open" allowing foods to pass through the intestines into the blood stream. This does cause many allergies, and parents had to be very careful. Because the recommended age is now six months, which is based on scientific learning of a baby's digestion, this one food at a time rule doesn't apply. However, if you have allergies in your family, it would be wise to introduce that food carefully, otherwise, there is no need to watch for a reaction for each food. If you still have reservations or are nervous, there is nothing wrong with following a 3-day wait when introducing new foods.

3) You have to introduce vegetables first. If you do fruit first the baby will develop a sweet tooth.
This is an old wive's tale. I've even heard that you have to introduce fruit first because the baby is used to sweet foods (breastmilk). A lot of pediatricians still recommend delaying fruits until after vegetables because that is what they were taught and it gets passed down the line. The AAP says that this has no scientific basis. Besides, breastmilk is the sweetest baby food around. As sweet as many fruits. Plus, how many toddlers do you know that refuse to eat any vegetables at all, and were still introduced to vegetables first as a baby?

4) A baby doesn't understand nutrition and needs their parent to feed them what they need.
This is true and false. A baby doesn't understand nutrition, but doesn't need you to feed them what they need. Rather, they need you to offer what they need. If offered a wide variety of healthy food, a baby will choose a variety of what they need. The book says that a baby actually will go for what they need at a particular time. Babies are not picky. They don't know they aren't supposed to like broccoli. In fact, broccoli is particularly interesting to a baby. Its bright, it has different textures and looks fun. The book also warns to be careful not to get into an eating rut. For instance, I have oatmeal every single morning. A baby would need a few different breakfasts throughout the week. A baby's nutritional needs should be judged weekly, not daily. A baby, left to her own devices, will pick a variety throughout the week. So even if they only eat banana one day, they will most likely try something else another day. Breastmilk (or formula) is a baby's main source of nourishment for the first year. Even if a baby is not truly "eating" much solid food, the milk feeds are perfectly adequate.

Benefits of allowing a baby to feed herself include: its enjoyable and natural, a baby is allowed to learn about food, learn to eat safely, gain confidence, they trust food, they are a part of the family meal, better nutrition, long-term health, they learn how to deal with textures and learn to chew, they experience real food, its easier and less complicated, no mealtime battles, less pickiness as a toddler, and finally, it is cheaper. The disadvantage: its messy.

I think the less pickiness as a toddler point is key. A baby is less likely to have food-related and eating issues if they are able to explore real food from the start. A lot of a child's food issues stems from texture, but a BLW baby explores food texture from the beginning so this doesn't become a problem later.

We just now started baby-led weaning. Mary Abilene is one week shy of six months. I don't know if six months is hard a rule, but she was really showing signs of readiness to start solids. She can sit upright on her own. She reaches for our food and she can chew, though she has no teeth. We have only been offering her solids for three days and already she has eaten, or rather, tried apples, carrots, deconstructed tostada, dahl (a lentil, onion, tomato puree), banana, orange, and stir fry. She loves oranges. Oranges are one of the only foods that she has really eaten so far. She takes the little wedge and sucks all the pulp out of the membrane. It is absolutely amazing. I did find broccoli in her poo too, so I know some of that got in her!

I am going to chronicle our baby-led weaning journey. We are doing good so far. She did gag the first two days a little. The first day was our fault because we gave her a raw apple and it was breaking off into little chunks. The gagging is scary, but she coughed it up then went about her business. We cook the apple for just a bit in the microwave and she is able to gnaw and suck on it much better. Day three she didn't gag at all. So she must be learning how to manage the food.

Baby-led Weaning is not new. I think a lot of people used to feed their baby this way before Gerber and the AAP. I also think a lot of people feed their baby this way now, they just do not talk about it for fear they will be seen as lazy or negligent. The weaning and the feeding could be two different subjects. This method combines them so the baby decides when she wants to nurse, when she wants to eat solids, or when she wants to give up nursing entirely. I think it will be easier and less stressful for me (as I love nursing) and for Mary Abilene since the breast will not just suddenly be off-limits. So will Mary Abilene still be nursing by the time she's three? Maybe. Probably. Depends on the child. That's just fine with me.